Purpose To evaluate, by means of optical coherence tomography (OCT) and OCT angiography (OCTA), early retinal, choroidal and macular perfusion changes induced by a local inflammatory reaction secondary to uncomplicated cataract surgery.
Methods Selected eyes undergoing cataract surgery were enrolled in a prospective study. OCT and OCTA were performed before cataract surgery (T0) and at day: 1 (T1), 7 (T7), 30 (T30) and 90 (T90). Inner (IR) and outer retinal (OR) volumes, choroidal volume, hyper-reflective retinal spots (HRS) in IR and OR changes were measured at OCT. Macular perfusion was analysed in superficial (SCP), intermediate (ICP) and deep retinal capillary plexuses (DCP).
Results Nine eyes of nine selected patients were consecutively enrolled. Mean IR volume changed after surgery (p=0.0001), increasing progressively from 4.391±0.231 mm³ at T0 to 4.573±0.241 mm³ at T30, p=0.0002. Both mean OR and choroidal volume increased, mainly at T30, but not significantly (p=0.4360 and p=0.2300, respectively). Mean HRS changed during follow-up, increasing at first in IR and later in OR (at T1 and T7, respectively, both p<0.0001). Macular ICP and DCP perfusion increased at T1, whereas macular SCP perfusion did not change. At T90, all OCT and OCTA parameters had almost reached baseline levels.
Conclusions The increase of HRS at first in IR and later in OR seems to confirm their inflammatory nature. Early OCTA changes (underline) underscore a selective susceptibility of DCP and ICP to a localised inflammatory reaction induced by cataract surgery.
- hyper-reflective retinal spots
- cataract surgery
- glial cells activation
- optical coherence tomography
- optical coherence tomography angiography
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FL and GS contributed equally.
Contributors EP and EM: substantial contributions to conception and design; acquisition of data; analysis and interpretation of data; drafting the article or revising it critically for important intellectual content and final approval of the version to be published. FL and GS: substantial contributions to design; acquisition of data; analysis and interpretation of data; drafting the article and revising it critically for important intellectual content and final approval of the version to be published. EL, TT and DD: substantial contributions to acquisition of data; revising the article critically for important intellectual content; final approval of the version to be published. FC: statistical analysis of data and final approval of the version to be published. GM and RP: substantial contributions drafting the article and revising it critically for important intellectual content; final approval of the version to be published.
Funding The research contribution by the G.B. Bietti Foundation was supported by Fondazione Roma and Ministry of Health.
Competing interests None declared.
Patient consent Obtained.
Ethics approval Institutional Review Board of Azienda Sanitaria di Padova.
Provenance and peer review Not commissioned; internally peer reviewed.